Barcelona Clinic Liver Classification for HCC

Question 1

Stage 0

Answer 1

Child-Pugh A
Single lesion (less than 2cm)
Normal portal pressures

Treatment - resection
5 year survival - 40-70%

Question 2

Stage A

Answer 2

Single nodule greater than 3cm or multiple nodules (no more than 3)
Child Pugh A/ B

Treatment - if associated disease then radiofrequency ablation, if no associated disease then transplantation
5 year survival - May be up to 70% in some

Question 3

Stage B

Answer 3

Multiple nodules
Child Pugh A/B

Treatment - trans arterial chemo-embolisation (usually with doxorubicin)
5 year survival - 26% at 3 years

Question 4

Stage C

Answer 4

Advanced tumours
Invasion of portal vein
Child Pugh A/B

Treatment - Sorafenib - oral multi tyrosine kinase inhibitor; improves survival from a median of 7 months to 10 months
5 year survival - usually survive 10.7 months

Question 5

Stage D

Answer 5

Child Pugh stage C
Advanced tumours

Treatment - best supportive care
5 year survival - less than 6 months survival